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Seminar on

Muscles of mastication
By : Dr.Sandesh.A.P

Introduction:
Man has 639 muscles , composed of 6 billion muscle fibers . each fiber has 1000 fibrils , which means that there are 6000 billion fibrils at work at one time or another. Muscles of mastication are the group of muscles that help in movement of the mandible as during chewing and speech. we need to study these muscles as they control the opening & closing the mouth & their role In the equilibrium created within the mouth. They also play a role in the configuration of face.

Development of muscles
# Zygote 2 cell stage 4 cell stage morulla---blastulablastocyte

# Formation of precordial bulge & cranial swellings # Formation of pharyngeal arches # Muscles develop from mesoderm of the pharyngeal arches

A
Amnion Wallo! yolk sac

Primitive pit and neurenteric canal

Cloacal plate (membrane)

Notochordal plate

Notochordal plate

Endoderm

Endoderm

Classification:
Muscles of mastication are mainly of four types a) Temporalis b) Lateral pterygoid c) Medial pterygoid d) Masseter Accessory muscles of mastication

a) b) c)

Buccinator Orbicularis Oris Mentalis etc .

masseter :
(most powerful muscle of mastication )

Origin and insertion: Quadrilateral muscle consisting of 3 layers a) Superficial layer: largest of the 3 layers. Arises -maxillary process of zygomatic bone - anterior 2/3rds of the inferior border of the zygomatic arch Inserted - angle& lower posterior half of the mandibular ramus. Intramuscular tendinous septa in this layer are responsible for the ridges on the bone

b) Middle layer: Arises - medial aspect of the anterior 2/3rds & lower border of posterior 2/3rds Inserts- central part of the mandibular ramus c) Deep layer: Arises- deep surface of the zygomatic arch Inserts - upper part of the mandibular ramus & coronoid process

Nerve supply: : Masseteric nerve ( nerve to masseter )


A branch of the anterior trunk of the mandibular nerve

Actions :
Elevates the mandible. - Its electric activity is minimal in resting position - Increases during orthodontic treatment & reduces after treatment(3)

Facial asymmetry in a 6-year-old girl with torticollis. Excessive muscle contraction can restrict growth in a way analogous to scarring after an injury. . Note that the asymmetry affects the entire side of the face, not just the mandible.

Temporalis:
Origin and insertion :
- Arises- whole of the temporal fossa & deep surface of the temporal fascia . Descends into a tendon which passes through the gap between zygomatic arch & the side of the skull. - Attaches- medial surface, apex , anterior & posterior borders of the coronoid process & the anterior border of the mandibular ramus almost to the last molar tooth . - anterior fibers -vertically , posterior fibers-horizontally, & intervening fibers- intermediate degrees of obliquity , in the manner of fan.

Nerve supply :Deep temporal nerves , (branch of anterior trunk of mandibular nerve)

Actions :- Elevates the mandible & so closes the mouth & approximates the teeth - contributes to side to side grinding movements . - retract the mandible (posterior fibers) - EMG activity of temporalis and masseter was (1) higher in classIII cases compared to class II & class I

Medial pterygoid :
Origin and insertion :Thick , quadrilateral muscle ,
Origin- medial surface of the lateral pterygoid plate & the grooved surface of the pyramid process of the palatine bone . - superficial fiber slip- lateral surfaces of the pyramidal process & the maxillary tuberosity . Attached by a strong tendinous lamina to the posteroinferior part of the medial surfaces of the mandibular ramus & angle , as high as mandibular foramen & almost as far forwards as the mylohyoid groove .

Nerve supply:Nerve to medial pterygoid

Actions :
- Assists in elevating the mandible . - Along with lateral pterygoid protrudes the mandible . when the medial& lateral pterygoid muscles of one side act together , the corresponding side of the mandible is rotated forwards & to the opposite side , - produces side to side movements which are used to triturate food.

Lateral pterygoid : Origin and insertion:


short thick muscle with 2 heads a) Upper head : Arises- infratemporal surface & crest of the greater wing of the sphenoid bone b) lower head : Arises - lateral surface of the lateral pterygoid plate ; Inserted - depression on the front of the neck of the mandible ,& into the articular capsule & disc of the TMJ. Lateral pterygoid muscles excision caused retardation of (2) growth in few rats minimal role in growth

Nerve supply:

Nerve to lateral pterygoid (branch of mandibular nerve )

Actions: a) Only muscle of mastication which helps in opening the jaw . Backward gliding of the articular disc & mandibular condyle is controlled by slow elongation of lateral pterygoid b)Acting with ipsilateral medial pterygoid , lateral pterygoid advances the condyle of that side about a vertical axis. c) When medial & lateral pterygoids of the two sides act together they protrude the mandible.

Orbicularis oris
Origin and insertion : consists of 4 independent quadrants (upper, lower, left and right) each of which contains a larger pars peripheralis and a pars marginalis Pars peripheralis is found in many mammals, pars marginalis is absent in non-primate mammals and uniquely developed with speech in the human Marginal and peripheral parts are apposed along lines that correspond externally to the lines of junction between the red-lip and the skin.

Pars peripheralis
Pars peripheralis has, in each quadrant, a lateral stem attached to the labial side of the modiolus over its full thickness. - stem fibers are thought to originate within the modiolus -reinforced directly by fibers from the following muscles: In the upper lip: from buccinator (Upper fibers and decussating lower central fibers) and depressor anguli oris In the lower lip: from buccinator (lower fibers and decussating upper central fibers), levator anguli oris and superficial part of zygomaticus major.

The fibers of orbicularis oris enter their respective superior and inferior labial areas and diverge to form triangular muscular sheets a) Thickest at the junctions between skin and red-lip b) Thinner as they reach the limits of the labial region The greater part of each sheet enters the free lip, where its fibers aggregate into cylindrical bundles orientated parallel to the red-lip margin. Fibers of the direct labial tractors pass to their submucosal attachments between these cylindrical bundles and between pars peripheralis and pars marginalis In the upper lip, highest fibers run near nasolabial sulcus; a few fibers attach to the sulcus, and a few to the nasal ala and septum. In the lower lip, the lowest fibers reach and attach to the mentolabial sulcus.

Pars marginalis
Developed to a unique extent in human lips and is associated with speech and the production of some kinds of musical tone. At their medial end fibers meet and interlace with their contra lateral fellows and attach to the red-lip dermis At their lateral ends; the fibers converge & attach to the deepest part of the modiolar base along a horizontal strip level with a buccal angle. In full thickness section at right angles upper lip --S shape lower lip -- continues curve

Nerve supply:

Lower branch & mandibular marginal branches of the facial nerve.

Scarring of the corner of the mouth is related to a burn at an early age. From equilibrium theory, one would expect a distortion in the form of the dental arch in the region of the contracting scar, and exactly this occurs.

Buccinator
Origin and insertion ;
quadrilateral muscle- occupies the interval between the maxilla and the mandible in the cheek. Attached to the outer surfaces of the alveolar processes of the maxilla and mandible opposite the molar teeth, and, behind, to the anterior border of the pterygomandibular raphe which separates the muscle from the superior constrictor of the pharynx.. The posterior part of buccinator is deeply placed, internal to the mandibular ramus and its attachments and in the plane of the medial pterygoid plate; its anterior part curves out behind the third molar tooth to lie in the submucosa of the cheek and lips.

Relations: Posteriorly, buccinator lies in the same plane as the superior pharyngeal constrictor and is covered by buccopharyngeal fascia. Superficially, a large mass of fat separates its posterior part from the ramus of the mandible, masseter and part of temporalis Anteriorly, the superficial surface of buccinator is related zygomaticus major, risorius, levator and depressor anguli oris, The parotid duct, pierces it opposite the 3rd upper molar tooth; crossed by the facial artery, facial vein and branch of the facial and buccal nerves. deep surface is related to the buccal glands and mucous membrane of the mouth.

Nerve supply.
Buccinator is supplied by lower buccal branch of the facial nerve.

Actions.
- Compress the cheeks against the teeth and gums; - During mastication they assist the tongue in directing food between the grinding molar teeth. - When the cheeks have been distended with air, the buccinators expel it between the lips. (Latin buccinator = trumpeter)

Mentalis :
Conical fasciculus lying at the side of the frenulum of the lower lip . the fibers arise from the incisive fossa of the mandible & descend to attach to the skin of the chin .

Actions :
Raises the lower lip , mental tissue & mentolabial sulcus wrinkles the skin of the chin Helps in protruding & everting (drinking ) Expresses doubt and disdain.

Nerve supply:

lower branch & mandibular marginal branches of the facial nerve.

modiolus
On each side of the face a number of muscles converge towards a focus just lateral to the buccal angle, where they interlace to form a dense, compact, mobile, fibromuscular mass: the modiolus palpated by thumb and index finger resembles a cart wheel blunt cone The base of the cone (basis moduli) is adjacent and adherent to the mucosa; The blunt apex of the cone (apex moduli) is about 4 mm across, and is centered about 12 mm lateral to the buccal angle

Cruciate modiolar muscles: zygomaticus major levator anguli oris depressor anguli oris platysma resemble X when vieved from apex transverse modiolar muscles buccinator risorius various parts of orbicularis oris incisive inferioris incisive superioris

Direct labial tractors:


pass directly into the tissues of lower lip & not via the moduli. the force exerted by tractors is directed vertically at approx. right angles to the fissure Upper lip :-- labial part of levator labii superioris alaque nasi, levator labii superioris & zygomaticus major Lower lip :--depressor labii superioris & pltysma pars labialis they are divided into superficial group intermediate group deep group

superficial group :- Comprises a succession of fine fiber bundles that curve anteriorly a short distance before attaching in a series of horizontal rows to the dermis between hair follicles, sebaceous & sweat glands deep group :- It is closely applied to the anterior surface of pars peripheralis O.Oris, between the parallel bundles of which it sends fine tractor fibers posteriorly to attachments on the submucosa & periglandular connective

intermediate group:- attaches to the dermis of modified skin of the red lip , which they reach by 2 routes More superficial bundles continue past the skin, red lip junction,then curve posteriorly over pars marginalis O. Oris to punctate attachments on the ventral half of the red lip margins Deeper bundles 1st pass posteriorly between parsperipheralis &pars marginalis then curve anteriorly punctate attachment on the dorsal half of the red lip dermis.

Movements of the lip :


act together or individually for ex partial contraction of superior labial tractors can result in localized elevation of segment of upper lip called the canine snarl Lip protrusion -passive in its initial state. It may be suppressed by powerful contrction of whole of orbicularis oris or enhanced by selective activation of the parts of the direct labial tractors Activity of tractors is modified by the superimposed activity of orbicularis oris & modiolar muscles

Buccinator mechanism
Bone is hardest tissue --most responsive to change when there is an alteration in the environmental balance The teeth & supporting structure are constantly under the influence of the contagious musculature.

WINDERS-- During mastication & deglutition, the tongue may exert 2 or 3 times as much force on the dentition as the cheeks at any one time . but the net effect is one balance as tonal contraction ,peripheral fibers recruitment of the buccal and labial muscles & atmospheric pressure team of to offset the momentarily greater functional force of the tongue

The buccinator mechanism runs lateral & posterior around the corner of the mouth, joining other fibers of the buccinator muscle which insert into the pterygomandibular raphe just behind the dentition. At this point it intermingles with fibers of the superior constrictor muscle & continues posterior& medially to anchor to the origin of superior constrictor muscle, the pharyngeal tubercle of the occipital bone. Opposing the buccinator mechanism is a very powerfull muscle--the tongue . The tongue begins its manifold activities even before birth, when it functions in the swallowing of amniotic fluid Best developed stucture in the body at birth

Buccinator mechanism
buccinator

Superior constrictor

orbicularis oris

pterygomandibular raphe

Lip, tongue and cheek balancing forces on the


teeth and supporting bony structures.

Lip, tongue and cheek balancing forces on the teeth and supporting bony structures

# MOSS states that coronoid process----temporalis muscles gonial angle--masseter and medial muscles

pterygoid

# SICHER supra orbital rim as a receptor of the forces transmitted to it by the canine & zygomatic pillars. # LISCHER, included the act of muscle of mastication as a factor in the restoration of normal occlusion by orthodontic therapy.

Principles of muscle physiology


Einthoven in 1918 muscle in contraction --idiomuscular current --action current
ALL OR NONE PHENOMENON

The intensity of contraction of any fiber is independent of the strength of the exciting stimulus provided that the stimulus is adequate. Muscle tonus: slight constant tension characteristic of all healthy muscle,. Tonus is basis of reflex posture Ex. Constant minimal contraction of antigravity muscle to maintain a standing position

Equilibrium Theory
dentition is in equilibrium If a tooth is subjected to a continuous force from an orthodontic appliance, it does move. The force applied by the orthodontist has altered the previous equilibrium, resulting in tooth movement. . The bony processes are influenced by the muscles attached. The density of the facial bones, like the skeleton as a whole, increases when heavy work is done and decreases in its absence.

Equilibrium Effects on the Dentition:


Heavy intermittent pressure has no impact on the long-term position of a tooth second possible contributor to the equilibrium is pressure from the lips, cheeks, and tongue. These pressures are much lighter than those from masticatory function, but are also much greater in duration

In this unfortunate patient, a large portion of the the cheek has been lost because of a tropical infection. The outward splaying of the teeth when the restraining force of the check is lost illustrates the effect of a change in equilibrium

Since the light pressures from lips, cheeks, and tongue at rest are maintained most of the time, one would expect these pressures to affect tooth position.
If an injury to the soft tissue of the lip results in scarring and contracture, the incisors in this vicinity will be moved lingually as the lip tightens against them. On the other hand, if restraining pressure by the lip or cheek is removed, the teeth move outward in response to unopposed pressure from the tongue resulting in labial displacement of the teeth even though the lips and cheeks are intact.

intermittent short-duration pressures created when the tongue and lips contact the teeth during swallowing or speaking would have any significant impact on tooth position
masticatory forces, the pressure magnitudes would be great enough to move a tooth, but the duration is inadequate. same reasoning can be applied thumb sucking Whether a behavior pattern is essential or nonessential, innate or learned, its effect on the position of the teeth is determined not by the force that it applies to the teeth, but by how long that force is sustained.

Equilibrium Effects on Jaw Size and Shape

Normal muscle activity associated with normal jaw relationship

Activity in class II malocclusion mandibular retrusion & excessive apical base difference

Activity in classII malocclusion with deep bite,the functional retrusion tendency

references
Grays anatomy38th edition Principles and practice of Orthodontics by T.M.Graber-3rd edition Contemporary Orthodontics by proffit Embryology I.b.singh Grants atlas of anatomy Gyton physiology

journals
Patterns of electromyographic activity in subjects with different skeletal facial types Rodolfo Miralles, Roberto Hevia. AJO DO-1991 Control of condylar growth - Whetten and Johnston AJO-DO 1985 sep Changes in masseter muscle activity during orthodontic treatment evaluated by a 24-hour EMG system Keisuke Miyamoto AJO DO 1996 NO.3 The "three M's": Muscles, Malformation and Malocclusion - GRABER 1963 AJO DO

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